This Korean staple relies on lactic acid fermentation (also called lacto-fermentation) to turn cabbage or other vegetables into a spicy, pungent side dish that's packed with vitamin C. Order it at Korean restaurants or buy it in the refrigerated section of your grocery store (King's Kimchi is widely available at Walmart). For some guidance on making your own, turn to The Art of Fermentation ($23; amazon.com). Then, use it to spike veggie-laden rice bowls, top on soup, or serve alongside meat.
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. "Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT." Cell (First published: September 6, 2018)  DOI: 10.1016/j.cell.2018.08.047

After the antibiotics had cleared the way, the standard probiotics could easily colonize the gut of everyone in the second group, but to the team's surprise, this probiotic colonization prevented the host's normal microbiome and gut gene expression profile from returning to their normal state for months afterward. In contrast, the aFMT resulted in the third group's native gut microbiome and gene program returning to normal within days.
The first major finding was that many people were essentially resistant to any effect from probiotics and their gut microbiome did not change after taking them.  Of 19 people in the study taking probiotics consisting of 11 of the most commonly found strains, only 8 had any notable colonization of their gut with the bacteria in the probiotics, with 3 people considered to have significant colonization and 5 people with "mild" colonization.
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Gut flora makes up 70 to 80 percent of the human immune system. Too much bad bacteria can inflame and destroy intestinal walls, enter the bloodstream, and trigger a multitude of health issues — constipation, depression, skin problems, autoimmune disease, and even bad breath. Adding good bacteria protects the digestive tract from the harmful bacteria in sugars, pesticides, and saturated fats. 

Many women are prone to yeast infections during or after antibiotic use. If you are one of these unlucky few, try taking a probiotic like the vH Probiotics with Prebiotics and Cranberry immediately before taking your antibiotics. (You may want to check with your doctor first though). These cultures may help with stomach upset and can also prevent a dreaded yeast infection!

Every day, we’re exposed to toxins and inflammation-causing molecules from food and the environment that negatively impact digestion through pathways, such as leaky gut, known in the medical field as intestinal hyperpermeability. In leaky gut, the tight junctions that are supposed to keep disease-contributing compounds from leaving the digestive system are disrupted, allowing a lot of things through into the bloodstream that don’t belong there.
Today, most of the Japanese population begins the day with a warm bowl of miso soup, believed to stimulate the digestive system and energize the body. Made from fermented soybeans, rice or barley, adding a tablespoon of miso to some hot water makes an excellent, quick, probiotic-rich soup. The fermentation process can take anywhere from a few days to a couple of years to complete, and the end result is a red, white or dark brown paste with a buttery texture.
“If someone has disrupted his gut microbial balance, this is where a probiotic can be of benefit,” says Gail Cresci, PhD, RD, an intestinal microbe specialist with Cleveland Clinic’s Department of Gastroenterology, Hepatology and Nutrition. “But whether it’s really going to help and whether you’re taking the right one are the big questions out there.”
Historically, people had plenty of probiotics in their diets from eating fresh foods from good soil and by fermenting foods to keep them from spoiling. Over a century ago, the Russian Nobel Prize winner Elie Metchnikoff theorized that “health could be enhanced and senility delayed by manipulating the intestinal microbiome with host-friendly bacteria found in yogurt.” Metchnikoff was ahead of his time with his view of probiotics benefits, but he also was aware that most citizens had regular access to probiotic foods.

"Many chronic health problems and inflammatory diseases are caused by a damaged microbiome where the good bacteria is overrun by the harmful bacteria and can't reinforce the gut walls, which results in increased intestinal permeability where bacteria and toxins leak through the intestines into the bloodstream triggering a system-wide immune response of inflammation that is a part of our body's natural healing cycle."
She totally did, but you may have noticed that you don't see those yogurt commercials anymore. That’s because in 2010, the Federal Trade Commission in conjunction with 39 states' attorney generals banned those ads, finding that the Dannon Company had no scientific evidence to back up their claims,. Dannon had to pay $21 million to resolve the associated investigations.

Some digestive disease specialists are recommending probiotic supplements for disorders that frustrate conventional medicine, such as irritable bowel syndrome. Since the mid-1990s, clinical studies suggest that probiotic therapy can help treat several gastrointestinal ills, delay the development of allergies in children, and treat and prevent vaginal and urinary infections in women.


Hi Julia. I am 71 (male) and have had digestive issues for most of my life and no specific diagnosis. I eat fairly well, am not overweight, get gassy from many different foods and beverages. I have been using Culturelle for 9 months and feel the benefit from taking it is small. Your review leads me to believe there may be better choices. They certainly are not cheap but I will gladly pay for them if they give me results. I am probably going to try BlueBiotics unless you have other suggestions. My main question is since I live in Minnesota I will receive shipments in the summer with temps of up to + 100F and winters down to – 15F. Will this cause a decrease in product viability for this or other brands you recommended? Thank you for your help.

In the past, probiotics have been proposed as part of a weight loss diet. However, a 2015 meta-analysis looked at available randomized, controlled trials investigating this effect and determined that the studies did not seem to support this hypothesis, as body weight and BMI were not consistently reduced. The researchers did point out the need for better designed trials, because they were not convinced the results were based on well-designed science. 

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When shopping for a probiotic, the first things to look at are CFUs count and probiotic strains. CFUs is the acronym for colony forming units, and is the measure of how many probiotic bacteria are capable of dividing to form colonies. In other words, the higher the CFUs, the higher the number of active, live good bacteria. Generally speaking, the higher the CFUs, the better, although there are exceptions.

​​​​​​Every woman’s microbiota is different and so results will vary. However clinical studies using the blend of probiotic strains in AZO Complete Feminine BalanceTM demonstrated benefits in as little as 7 days. We suggest continuing with use of the product for a minimum of 30 days. Also, keep in mind that for regular maintenance, you may not SEE results but the product is still helping to protect and maintain a healthy vaginal flora.*
The U.S. Clinical Guide to Probiotic Products1, Canadian Guide to Probiotic Supplements2 and the WGO Global Guidelines for Probiotics and Prebiotics3 provide suggested effective amounts of specific strains for treating certain health conditions, such as constipation or IBS. All 37 products listed the species of bacteria they contained, but only 14 listed amounts of individual strains. We found that 9 of those 14 products provided beneficial bacteria at effective levels. The Center for Responsible Nutrition recommends4 the industry move toward specifying strains as a best-practice because whether a product works and for what purpose depends on its strains.
Method of delivery: "The probiotic needs to be able to survive the acidic environment of the stomach and reach the intestine," explains Dr. Nazareth. This can be optimized through the way you take the probiotic and what's included in the formula. "Some delivery systems to consider are time-released tablet/caplet, capsules with an enteric coating and/or microcapsules, and ones that contain prebiotics and the optimal combination of probiotics," says Lori Chang, a registered dietitian with Kaiser Permanente in West Los Angeles.
Science uncovers more about the microbiota and the critical role it plays in our health. A daily dose of a research-proven probiotics can help correct dysbiosis, support your gut health (in a preventive way, or for more chronic ailments) or give your system an added boost when you need it, like after a course of antibiotics or when you are travelling. When choosing to add a probiotic into your health plan, be sure to understand why you are taking it, what dosage you need, what the specific probiotic strains are good for, and if it has the research to back up what it’s claiming to do.
Because chronic inflammation is at the root of many diseases and health conditions, the fact that probiotics exert this effect in the gut, where 80 percent of the immune system lies, is crucial. The immune-boosting benefits of probiotics seem to be particularly helpful for the quality of life of seniors. Currently, research is underway to test whether probiotics can “reduce inflammation and improve gut immune health in HIV-positive individuals” who haven’t yet undergone treatment.
33 of 37 passed all purity tests, indicating an absence of harmful contaminant yeast, mold residues and bacteria, including the pathogenic strain of E. coli (E. coli O157:H7), Salmonella spp., and Staphylococcus aureus. The U.S. Pharmacopeia6 recommends a microbial limit of 100 CFU/g of combined yeast and mold in dietary supplements and non-detectable limits of E.coli, Salmonella, and Staphylococcus aureus. If a product met these standards, it received a full score.

If you are seeking non-dairy yogurt options, there are several that contain live probiotic cultures. Yogurts made from rice, soy and coconut milk are available on the market and also contain added probiotics that can provide the same benefits. Other alternative sources of probiotics include eating fermented foods like Brewer’s yeast, miso, sauerkraut, or micro algae. Whatever the source, always look for “live and active cultures” on the label.
Most people with diverticulosis have few if any symptoms at all. When people do experience signs and symptoms of diverticulosis (diverticular disease) they may include abdominal pain, abdominal cramps, diarrhea, constipation, and bloating. Diverticulitis is a condition in which diverticuli in the colon rupture. The rupture results in infection in the tissues that surround the colon. Treatment methods for diverticulitis includes prescription medications, and in some cases, diverticulitis surgery.
However, it is not just digestive woes that probiotics can help address. A clinical case series followed 300 patients who took a probiotic mixture of L. acidophilus and L. Bulgaricus. They documented that 80% of acne patients had some degree of clinical improvement, particularly effective in inflammatory acne. Later, an Italian study involving 40 patients found L. Acidophilus and B. Bifidum supplementation produced better clinical outcomes in acne as well as better tolerance and compliance with antibiotics [2].
"The skin and the gut go hand in hand," explains Shapiro. "Since probiotics help improve the gut microbiome and aid in reducing inflammation, skin conditions will also improve. When eating a healthy, whole food diet as well, skin conditions get better over time. When the gut is not intact, other parts of the body also start to break down and become toxic. With probiotics, your gut becomes healthier and therefore, your skin problems start to disappear. "
Then, study participants were divided into one group that consumed a standard probiotic strain available in commercial supplements and a control group that was given a placebo. After two months of treatment, the researchers found that some people were so-called “resisters” who expelled the gut microbiomes in probiotics; others were identified as “persisters” who successfully colonized the generic probiotic strains in their GI tracts.
Some yogurts contain the aforementioned bacteria; however, because they are sensitive to oxygen, light, and dramatic temperature changes, make sure to look for yogurts with “live and active cultures.” Many commercial yogurts are heat-treated or pasteurized, resulting in the loss of these valuable cultures. Learn more about the smart way to shop for probiotics.
The Number of CFUs The quality of a probiotic supplement has more to do with strains and how many CFUs it provides. (CFU stands for colony forming units, and it refers to the amount of live microorganisms in your supplement.) Although recommendations may vary, Gans says to look for probiotics with at least 1 billion CFUs: “Doses will typically range from 1 billion to 10 billion CFUs for adults; although doses for children are often under 1 billion.”
"Although all of our probiotic-consuming volunteers showed probiotics in their stool, only some of them showed them in their gut, which is where they need to be," co-senior author Eran Segal, a computational biologist at the Weizmann Institute, said in the statement. "If some people resist and only some people permit them, the benefits of the standard probiotics we all take can't be as universal as we once thought."
"People have thrown a lot of support to probiotics, even though the literature underlying our understanding of them is very controversial; we wanted to determine whether probiotics such as the ones you buy in the supermarket do colonize the gastrointestinal tract like they're supposed to, and then whether these probiotics are having any impact on the human host," says senior author Eran Elinav, an immunologist at the Weizmann Institute of Science in Israel. "Surprisingly, we saw that many healthy volunteers were actually resistant in that the probiotics couldn't colonize their GI tracts. This suggests that probiotics should not be universally given as a 'one-size-fits-all' supplement. Instead, they could be tailored to the needs of each individual."
There are four significant takeaways from this study: (1) murine gut mucosal probiotic colonization is only mildly enhanced by antibiotics, (2) Human gut mucosal probiotic colonization is significantly enhanced by antibiotics, (3) After taking antibiotics, probiotics delay gut microbiome and transcriptome reconstitution in mice and humans, (4) Autologous fecal microbiome transplant (aFMT) restores mucosal microbiome and gut transcriptome reconstitution. 
Other foods without substantial research: miso (fermented soybean paste); tempeh; sauerkraut; aged soft cheese; sourdough bread; sour pickles; gundruk (nonsalted, fermented, and acidic vegetable product); sinki (indigenous fermented radish tap root food); khalpi (fermented cucumber); inziangsang (traditional fermented leafy vegetable product prepared from mustard leaves); soidonis (widespread fermented product prepared from the tip of mature bamboo shoots)
All probiotic strains are manufactured through fermentation, and are then freeze-dried before blending with fructooligosaccharides (FOS). The result is a shelf-stable (two years at room temperature), nitrogen-filled probiotic of human origin: a probiotic that easily adapts to your body, and is both acid- and bile-resistant to survive the acidic environment of the human stomach. In other words, a probiotic that fulfills its promises.
The takeaway: Certain strains were found useful in preventing diarrhea among children being prescribed antibiotics. A 2013 review showed that after antibiotic use, probiotics help prevent Clostridium difficile-associated diarrhea. A review focused on acute infectious diarrhea found a benefit, again for certain strains of bacteria at controlled doses. There’s also evidence that they may help prevent necrotizing enterocolitis (a serious gastrointestinal condition) and death in preterm infants.
We are clearly getting to the strain level by going beyond “Saccharomyces boulardii” and to “Saccharomyces boulardii CNCM I-745”. They did a great job by actually putting it on the label so you don’t even have to contact the company to see exactly what strain you’re getting. (P.S. this is a well-researched strain that I highly recommend, especially for preventing antibiotic-associated diarrhea.)
Bottom line: Probiotics are a promising field of research and may one day be used to treat or help prevent many disorders. But there’s not enough solid evidence to recommend their widespread use. Vague claims that probiotics "support good digestive health" are meaningless. Larger, longer and better studies are needed to test specific strains for specific conditions and to determine the proper doses and regimens.
If you’re new to Bio-K+, know that each bottle contains 50 billion live and active probiotic bacteria. Probiotics are good for a wide variety of digestive issues, so it’s best to customize your dosage based on what your specific needs are. If you are looking to take a preventative dosage to support the health of your microbiome, start with a ¼ bottle per day. If you suffer from digestive health issues or regularly take antacids, start with a ½ bottle of Bio-K+ per day. If you have more serious gastrointestinal issues or have had to take antibiotics, Bio-K+ probiotics are great for getting your system back on track. Start with a full bottle per day and see how you feel (we’ve had amazing results from our fans!)
The right resident strains - quite a few probiotics on the market contain things like active yeasts or soil based organisms. While these ingredients may be helpful to some, if you want to optimize your gut health, you need to look for strains that are resident to the human gut like those from the Lactobacillus, Bifidobacterium, and Streptococcus families. 

Bacteria in your digestive tract can be good or bad, according to the website Best Probiotic. It quotes the Royal Academy of Medicine England as blaming an imbalance between good and bad bacteria for causing 80 percent of all degenerative diseases. Probiotic supplements with "good" bacteria have become increasingly popular. They can aid the immune system, digestion and vitamin absorption, as well as prevent diarrhea and irritable bowel syndrome. The website Women to Women recommends probiotics that combine saccharomyces, lactobacillus acidophilus and bifidobacteria in the billions. MayoClinic.com also recommends lactobacillus and advises looking for products that contain live, active cultures. You should always check with your doctor before adding any supplements to your diet.
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